Arthritis of your ankle can cause varying levels of problems. Some people may have no symptoms at all. Most people experience pain with moving their ankle, particularly when bearing weight (walking or running). This may lead to the development of a limp or even turning your foot outward when walking (a way of your body limiting the movement of the ankle).Some people develop stiffness in the joint.
Trying different types of footwear or modifying activity levels may help alleviate the problem. Pain medication may also be useful. For a few people, however, more invasive treatment may be needed. This can be in the form of steroid injections or surgery.
If surgery is needed in these cases it falls into two main categories – fusion or replacement (for established arthritis there is usually no role for arthroscopic, or keyhole, surgery although this may occasionally be used in early disease or when only a small portion of the joint is affected).
Joint fusion is surgery to stop the joint moving completely. In cases when this is recommended there would usually already be very little movement in the joint but with pain. We would therefore be aiming to convert a stiff and painful joint into one that is stiff but largely pain free. Specially designed titanium screws or staples would be used to hold the joint still after removing the damaged joint lining.
In some cases a replacement may be an option. Again, the focus is on relieving pain but this time with the added potential advantage of maintaining some movement of the joint. Once the damaged joint lining is removed, a metal and plastic prosthesis is inserted between the two bone ends to allow movement. Ankle replacement surgery is complex and not offered in all hospitals. At Wrightington Hospital we carry out approximately 10% of all the ankle replacements in the UK.
Most surgery to the ankle would be carried out under either a general anaesthetic (with you asleep) or a spinal anaesthetic and in almost all cases you will require an overnight stay. You will be encouraged to rest as much as possible for the first 3 weeks in order to allow the wound to heal before the stitches are removed.
If a fusion procedure is performed you will be in a plaster cast for the first 3 weeks and be required not to put any weight through this. You would then use a special walking boot from 3 weeks until 3 months after surgery.
For replacement surgery you will be in a plaster cast for the first 3 weeks but allowed to walk on this. At 3 weeks you will then use a special walking boot up until 6 weeks after surgery.
During your consultation the most appropriate of the above treatments will be discussed including the relevant benefits and complications of each one.